# Noninvasive histotripsy ablation of fibrotic tissue in benign prostatic hyperplasia

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 2021 · $596,221

## Abstract

PROJECT SUMMARY
Benign prostatic hyperplasia (BPH) is the most common cause of bothersome lower urinary tract symptoms
(LUTS) in men affecting half by age 50 and about 90% of men by age 80. BPH is characterized by hyperplastic
growth of glandular epithelial cells and fibromuscular stromal cells, leading to enlargement of the median and
lateral lobes of prostate. The resulting bladder outlet obstruction impedes the flow of urine through the prostatic
urethra, accounting for the development of LUTS (urgency, frequency, weak stream, straining, hesitancy,
intermittency and night time voiding). Although current surgical management of BPH is efficacious, the increasing
age and morbidity of this patient population has resulted in considerable clinical need for equally effective but
less invasive and less morbid procedures. Histotripsy is an emerging noninvasive technology that applies short,
high-amplitude focused ultrasound pulses to mechanically disintegrate tissue. Histotripsy is being investigated
for a variety of diseases, including benign prostate hyperplasia, thrombosis, tumor treatment, and congenital
defects. Investigations of the technology have strongly focused on soft tissues that are primarily cellular; the
bioeffects, imaging and gross signatures of tissue breakdown, histological analysis, exposure parameters, and
other aspects of the treatment are characterized and progressed based on the response of soft, glandular
tissues. However, many of these diseases including BPH contain a critical fibrous component. Preliminary data
indicates that different histotripsy exposures can achieve either fibrous tissue sparing or ablation. In this
proposal, we aim to characterize the physical and biological effects of histotripsy on fibrotic tissue, evaluate
promising treatment strategies to treat such tissue, and apply these methods specifically to improve histotripsy
of the prostate. We propose to develop physical and numerical models for bubble-fibrous matrix interaction and
characterize the physical effects of histotripsy exposures on fibrous structures using ultrasound and optical
imaging methods. New exposure strategies will be tested to promote disintegration of fibrous tissue and
identification of tissue disruption via ultrasound imaging feedback. Advanced strategies will be tested in ex vivo
human prostate specimens to confirm improved ablation. Acute and chronic bioeffects will be assessed in a
canine model of BPH. We will also measure changes in voiding patterns and urodynamics between treatment
groups to demonstrate symptomatic improvement. The successful implementation of this project will overcome
existing obstacles to clinical implementation of histotripsy for BPH and aid development of histotripsy for other
applications.

## Key facts

- **NIH application ID:** 10183239
- **Project number:** 5R01DK119310-03
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Adam Douglas Maxwell
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $596,221
- **Award type:** 5
- **Project period:** 2019-09-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10183239

## Citation

> US National Institutes of Health, RePORTER application 10183239, Noninvasive histotripsy ablation of fibrotic tissue in benign prostatic hyperplasia (5R01DK119310-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10183239. Licensed CC0.

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